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ARCHIVED REPORTS_XR0005169
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MONTE DIABLO
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1766
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2900 - Site Mitigation Program
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PR0535112
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ARCHIVED REPORTS_XR0005169
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Entry Properties
Last modified
9/24/2020 12:04:53 AM
Creation date
3/17/2020 3:10:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005169
RECORD_ID
PR0535112
PE
2957
FACILITY_ID
FA0020296
FACILITY_NAME
CHAPIN BROTHERS INC
STREET_NUMBER
1766
STREET_NAME
MONTE DIABLO
STREET_TYPE
AVE
City
STOCKTON
Zip
95203
APN
13505050
CURRENT_STATUS
01
SITE_LOCATION
1766 MONTE DIABLO AVE
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc 0 G <br /> Date Page 4— Of <br /> 4005!North Wilson Way-Stockton,California-96205-(209)467-1006-Fax(209)467-1118 <br /> Client Pmiect ag r <br /> Tests Required <br /> P ne Number <br /> 6�� �Nkl 6, <br /> Sa (Signature)&6-5 , ---I- -- - nvoice <br /> AGE <br /> Protect Name Client ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid No of//J /Notes <br /> Number Description Air Canis <br /> Comp Grab <br /> MUM/0-7-91 #-1 -7/91/00 l7 y 44138 <br /> 44139 <br /> 44140 <br /> L] x 44141 <br /> t� 1ix 111 44142 <br /> IAIJ _ �1 44143 <br /> y <br /> �- K D 44144 <br /> ehnq y ignature ece ad by (Signature) Uatei,,,,,a i <br /> Relmquished by (Signature) Received by (Signature) Date(Time <br /> Relinquished by (Signatures) Received by Mobile Laboratory for field analysis (Signature) Dateffime <br /> Dispatched by (Signature) Date/Time Received for Laboratocw by IDatetTline <br /> $'34 a�+n <br /> Method of Shipment Lab atory ame <br /> lAalk I <br /> Special Ins c ons l hereby i raze ih performance of the above indicated work <br /> MON!WTI <br /> 0 n Lw_t�.V-'Z-- M, 0,0 F, <br /> MMI-2701--m- <br />
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